Published on AJMC.com

With healthcare in the spotlight after this week’s midterm elections, there are a number of things elected officials can do to encourage hospital safety, said the head of the Leapfrog Group as it released its fall 2018 rankings of Hospital Safety Grades.

The ratings, released Thursday, assessed more than 2600 hospitals across the country and found that serious harm or death from medical errors are problematic.

“We’re hoping to see both at the state level and the federal level better public reporting of all of the measures of safety in hospitals, including infection rates,” said Leah Binder, president and chief executive officer of Leapfrog, in an interview with The American Journal of Managed Care®.

It doesn’t matter if a state leans blue or red, said Leapfrog, which tried to put an electoral spin on the results. In blue states, 33% of hospitals received “A’s,” compared with 32% of hospitals in red states.

New Jersey, which was number 17 in the rankings last spring, rose to first place, while Hawaii, which ranked first in the spring, fell to 20th place. Idaho, which ranked number 2 in the spring, fell to 27.

Leapfrog assigns “A,” “B,” “C,” “D” and “F” letter grades to general acute-care hospitals.  The grades are based on hospital errors, accidents, injuries and infections. Preventable errors and infections in hospitals kill more than 500 people every day in the United States, according to previous research.

Overall, the 5 states with the highest percentage of “A” hospitals this fall are New Jersey, Oregon, Virginia, Massachusetts, and Texas. The 5 states with the lowest percentage of top-ranked hospitals are Connecticut, Nebraska, Washington, DC;  Delaware, and North Dakota.

Binder said she would like to see more public reporting of infection rates from the CDC. For instance, she said, if a healthcare company includes a network of 5 or 6 separate hospitals, infection rates are not broken out by individual institution, but rather are reported in the aggregate.

“We just think there’s a wealth of information out there that consumers deserve to have that they don’t have about the safety and quality of care, particularly safety,” she said.

There are a number of actions elected officials can take make to improve hospital safety, Binder said. As one example, if a state is reviewing government bonds or grants for an institution, they could incentivize the approval by considering the safety record as part of the process.

“There are a variety of ways states could reward excellence and demand improvement when excellence is not available,” she said.

With the results of midterm election known, Binder said she is “cautiously optimistic” about improvements at the federal level. In 2019, Democrats will control the House of Representatives, while Republicans will retain the Senate.

“I think now that the election behind us, the opportunity to restore that kind of conversation is before us and I am excited to see that happen with both houses of Congress,” she said.

The Leapfrog survey is drawn from 28 measures of publicly available hospital safety data, including from the CDC, CMS, the Leapfrog Hospital Survey, the Agency for Healthcare Research and Quality (AHRQ), and the American Hospital Association’s Annual Survey and Health Information Technology Supplement.

In this report, Leapfrog expanded its rating methodology to include an assessment of hospital use of Bar Code Medication Administration (BCMA), which helps reduce the risk of giving the wrong medication to a patient. But Binder said she did not think the change in methodology would account for some of the shifts that some states experienced, like Idaho.

In a statement, the president and chief executive officer of the New Jersey Health Care Quality Institute said it was the first time the state reached the number one spot in the survey, which relies on voluntary participation from hospitals.

“We’re proud of the high number of hospitals in New Jersey that voluntarily submit their quality and safety data to Leapfrog, and then also use that information to continually improve patient care,” said Linda Schwimmer. “Our experience shows that hospitals committed to creating a culture of safety and quality perform well. That’s the common denominator,” she said.